Understanding public confidence in locally-produced mRNA vaccines: Insights for future pandemic preparedness.

As local vaccine manufacturing becomes a strategic goal for future pandemic preparedness, investigating public trust in domestic vaccine production is essential for ensuring equitable uptake and long-term success. A cross-sectional web-based survey was conducted to assess confidence in the local scientific community, manufacturers, regulatory authorities, and locally-produced mRNA vaccines. A vaccine confidence index (VCI) captured attitudes toward mRNA vaccine safety, efficacy, and acceptability. In multivariable logistic regression analysis, confidence in the competency of the local scientific community (aOR = 1.55, 95% CI: 1.14-2.10, p < .01), local vaccine manufacturers' ability to produce high-quality vaccines (aOR = 1.95, 95% CI: 1.46-2.59, p < .001), and trust in the quality of locally-produced vaccine products (aOR = 2.39, 95% CI: 1.79-3.20, p < .001) were significantly associated with greater confidence. Confidence in regulatory authorities also played a key role; participants who believed regulators were competent (aOR = 1.95, 95% CI: 1.44-2.63, p < .001) and trustworthy (aOR = 1.72, 95% CI: 1.22-2.43, p < .01) were more likely to express confidence. Under VCI, perceiving mRNA vaccines as important for children (aOR = 1.63, 95% CI: 1.09-2.43, p < .05), safe (AOR = 2.95, 95% CI: 1.84-4.72, p < .001), effective (aOR = 2.00, 95% CI: 1.26-3.13, p < .01), and aligned with personal beliefs (aOR = 2.31, 95% CI: 1.43-3.75, p < .01) significantly increased confidence. Ethnicity was the strongest demographic predictor, with Malays showing significantly higher confidence (aOR = 1.88, 95% CI: 1.15-3.07) than other groups. Findings underscore the need for transparent, evidence-based, and culturally tailored strategies to build trust and advance Malaysia's vaccine self-reliance goals.